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目的探讨胃肠道间质瘤(GIST)的诊断和治疗。方法回顾性分析53例GIST的临床和病理资料。结果本组GIST位于胃25例,十二指肠2例,小肠19例,结肠4例,直肠3例。超声内镜确诊率68.8%(11/16);双源CT检查7例,阳性率71.4%(5/7)。CD117阳性率88.7%(47/53),CD34阳性率66.0%(35/53)。病理诊断良性间质瘤16例,交界性9例,恶性28例。本组均行肿瘤局部切除或局部消化道部分切除。53例随访6～72个月,16例良性间质瘤患者全部存活,28例恶性及9例交界性间质瘤患者中2例于术后10个月复发,4例术后18个月发生转移,10例术后36个月死亡。结论超声内镜结合双源CT是临床诊断GIST的主要方法,确诊需依靠组织病理学检查和免疫组化染色,外科手术是GIST治疗的首选,对恶性或潜在恶性的胃肠间质瘤患者需行甲磺酸伊马替尼辅助治疗。
Objective To investigate the diagnosis and treatment of gastrointestinal stromal tumors (GIST). Methods Retrospective analysis of 53 cases of GIST clinical and pathological data. Results The group of GIST located in the stomach 25 cases, 2 cases of duodenum, 19 cases of small intestine, colon 4 cases, rectum 3 cases. Ultrasound endoscopy confirmed the rate of 68.8% (11/16); double-source CT in 7 cases, the positive rate of 71.4% (5/7). The positive rate of CD117 was 88.7% (47/53) and the positive rate of CD34 was 66.0% (35/53). Pathological diagnosis of benign stromal tumors in 16 cases, 9 cases of borderline, malignant 28 cases. This group of patients underwent partial tumor resection or partial gastrointestinal resection. Fifty-three patients were followed up for 6 to 72 months. All 16 patients with benign stromal tumors survived. Two of 28 patients with malignant and 9 borderline stromal tumors relapsed 10 months after operation and 4 patients 18 months after operation Metastasis, 10 patients died after 36 months. Conclusion Endoscopic ultrasonography combined with dual-source CT is the main method of clinical diagnosis of GIST. Confirmed by histopathological examination and immunohistochemical staining, surgical treatment is the first choice of GIST treatment. For patients with malignant or potentially malignant GISTs Imatinib mesylate adjuvant therapy.